Alabama Durable Medical Power of Attorney Form

The Alabama durable medical power of attorney form is a document written to solely elect an individual, known as the attorney-in-fact or agent, to make decisions on the part of someone else. The principal may choose up to two (2) people, in the chance one of them cannot be present, and either will have the power to make health care decisions going as far as ending the person’s life if they are in an untreatable condition.

How to Write

Step 1 – Begin by opening in Adobe PDF and filling-in the form on the first page:

  • Date
  • Name of principal and their address
  • Telephone
  • Attorney in Fact’s name, address, and telephone number(s)
  • Successor Attorney in Fact’s name, address, and telephone
  • 2nd Successor Attorney in Fact’s name, address, and telephone

Step 2 – On the 3rd┬ápage enter the following:

  • If the principal has an incurable condition where death is imminent they may be able to write special instructions as to whether to keep their life going or shut off feeding tubes if death should happen in a week or less.
  • If death is estimated to be within three (3) months or less the principal may be able to write the treatment options they would like for themselves.
  • If the principal would like to fill-in any other special conditions it should be entered.

Step 3 – On page 4 the Declarant should sign the document and also sign a second (2nd) time stating that they were emotionally and mentally competent at the the time of of signature.

Step 4 – On page 5 the witnesses must sign (2 minimum).